The authors of “Choose Your Foods” should choose their words with as much care

November 30, 2012

I had a visit with a diabetes dietician today.  The meeting went well, but I was taken aback.  I oftentimes get a vibe from health care professionals that they think I’m pretty screwed up with my diabetes management.  Today the dietician said multiple times that she thought I was doing excellent.  She actually said it at least twice, once using the word “great” to exalt my efforts; excellent is the word she used the second time.  This was after downloading all my meter readings and hearing the tales of the last months, and the 30 years that led to those conditions.

The reason I was taken aback is because I did not get that negative vibe.  If anything I got more of a “you don’t really need my help” kind of vibe.  That’s a good vibe to get, and I have to get used to it.  I want to be used to it.

I got a lot of handouts from that visit.  One was called “Choose Your Foods / Exchange Lists for diabetes.”  The reason I got that handout was because I asked about alcohol.  The word exchange always bothered me for many reasons.  It doesn’t seem like a real scientific unit of measure.  I know exchanges translate to more precise units but two problems I have with that.  That translation, or conversion more accurately, is different for each type of food so there isn’t an easy to remember standard.  This book, BTW reminds me of all the big books I got as a kid.  Something about them just speaks to the idea that you should stay at home in your little bubble of carb-counting and eat your fixed amounts of food without variation.

Scan0006

Don’t teach me how to follow a plan; especially one that I did not make.  Instead, teach me how to adapt to any given situation so I can adjust appropriately if something does not follow the plan, which happens often.

Let me stop the micro rant within my primary rant and get to the point.  On page 53 of this book, under “[alcohol] Selection Tips” it states that “While alcohol, by itself, does not directly affect blood glucose….”

Whoah, Nellie.

It does not directly increase  your blood glucose, but it certainly affects it.  Lowering is an effect, dear author.

This is the kind if confusing crap that makes it harder to manage your glucose.  Had I not known any better, I might read that and think I could do shots of vodka all night and I’d be fine.  Wrong.  I’d be dropping into a diabetic coma while being drunk on top of it.  I’ve been there.  Not the coma, but all the most serious effects of low blood sugar combined with being drunk is a really trippy place to be.  As great as that sounds to you recreational drug users out there, it’s not because you didn’t plan to get to that “high” and therefore not really sure when you’ll come down.  You’d always wish you weren’t there if you were cognizant enough to generate that thought.

A lot of the info you get on diabetes assumes you’re in a very controlled environment.  There should be more info out there for people on how to deal with all the variations.  Don’t give people a static list of a bunch of food and their “exchange” amount.  Teach people how to solve the problem up front and don’t try to program them into an un-shifting regimen.  I hate to use the word problem, but I’m speaking entirely from a mathematical point of view.  How do I adjust the scope, slide the scale, hit that curve ball?

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Posted by breeze773

The Medical Virtues of Miller Lite

November 27, 2012

Old School Miller Lite.  Available in pharmacies across the country.

“It’s about time!  The guy with the alcohol-related blog is finally writing something about alcohol.”  Said the three people who looked at this blog so far.

First of all, let me give props to Courtney Benefiel and her blog article.  I know neither of us are doctors, but that article was the most realistic take on drinking with diabetes I’ve seen or heard to date.

In my previous post, I mentioned a loss of vision I have been dealing with recently.  (Those of you keeping tabs at home will be happy to now that when I look at the monitor with my bad eye now, I can make out letters on the screen if they are in bigger font sizes.)

Alcohol lowers your blood sugar but read on because I don’t think people always fully understand that statement.  I didn’t.  Consumable alcohol, ethanol, in its purest form lowers your blood sugar.  As to why, I still don’t know, but the point is unless you’ve got a serious drinking problem and access to an industrial chemistry lab, you probably aren’t drinking pure ethanol.  So we throw in different types of alcohol fermented from different things, mixed with different soft drinks all of which have a different carb to alcohol ratio.  Figuring out how much insulin to take–or not–with any of those in the mix isn’t quite as complicated as “…trying to hit a bullet with a smaller bullet whilst wearing a blindfold, riding a horse.” but it’s close.

Travel back about 18 years with me.  The bar I worked at in college boasted the largest selection of micro brews in town.  Dutiful employee that I was, I felt the need to get intimate with our wares.  I sampled every bock, stout, lager, cider and pale ale we had; continuously.  Every time a new beer rolled into the keg room I tried it.  I became a beer snob.  Luckily, there was a point where “lighter” (read shittier) beers became fashionable.  Though I am not susceptible to fashion trends when it comes to clothes, I am a sucker for them when it comes to beverages.  Anyway, those lighter beers still weren’t of the Miller Lite variety.  I’m talking more along the lines of Point and Blatz.  They may have had less of a carb to alcohol ratio than better microbrews but they still wouldn’t have made managing my blood sugars any easier.  Not that I would have noticed.  I was lucky if I was testing my blood once a month.  I mention this because I still know plenty of beer snobs today.  Some of which love to give me shit if they see my fist around can of Miller Lite.  There’s a reason, guys.  I may not have been conscious of it until recently, but there was a reason.

Back to the here and now.  That loss of vision I mentioned above shocked me into taking booze off the menu for about a month.  But, my 20-year high school reunion was coming up and whether I drank there or not was going to be a game time decision.

The day of the reunion, my wife and I checked into a hotel in the Milwaukee area to enjoy some pool time.  We had dinner with some very good friends planned for pre-reunion psych up, but we needed a snack until then.  As most hotels are wont to do there was an Outback Steakhouse conveniently located next door.  I ran over there to get a few appetizers for ourselves.  As I am wont to do, I sat at the bar to wait for our order.  Usually in this scenario I have a beer while I’m waiting, so I whipped out my phone and started googling.  I found and skimmed Courtney’s article.  I want to give her props because I found that article to have a style and tone I had previously not found on the topic of diabetes.  I liked it a lot.  But, my immediate takeaway from that skimming was that of all beers, lite beers like Miller Lite, have a carb to alcohol ratio that is easiest to manage and predict.  So, I ordered a Spotted Cow.  Idiot.  This was well before the reunion where I felt I would have more freedom to test and inject if needed, so I put the Miller Lite info into the middle of my head for later use.
According to the ole logbook that Spotted Cow, and some cheese fries made my blood sugar go from 88 to 157.

Indy Notebook

Keep a good log at all times.  Even in the map room.

That was the only beer I had–for a while.  I did, however have a couple Captain and Diets as the reunion went along.  Thanks again to the good ole logbook, I see that had an affect of lowering my blood sugar to 56.  It was 201 after we  finished dinner.  I got into panic mode a bit at that time.  Not just because my blood sugar was dropping, but because of it I started sweating profusely in front my old high school girlfriend.  We would have had a nice conversation, by the way, but I aborted to run into the restroom to swab off my forehead and down about a half dozen life savers.

The sweating stopped and I could feel myself getting higher.  At this point I switched to Miller Lite and dove into the appetizers.  I can’t remember how many beers I drank, but it was enough to get me drunk.  I’m sure the captain and diets help a lot on that front too.

The next morning when I tested I was at 120.  Right on the money.  I’d like to thank Miller Lite as my safety drink and bestow its virtues, but there are other tales to come that make me think I don’t quite have it figured out yet.  I tend to munch after longer nights of drinking and that may have something to do with it.

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Posted by breeze773

You can’t have an Indy without an Eye

October 22, 2012

<fiction>

I became a deckhand as part of Captain Katanga’s crew for his pirate ship.  As such, I thought wearing an eye patch would help me better fit into my  role.

This renegade archaeologist, his lady friend and some mysterious cargo came aboard while we were docked in North Africa.

At first their presence didn’t excite my life at sea much.  The only change I noticed was that I had to remove a lot more rat carcases after we set sail.  I assumed the captain found some new poison for the vermin at port.

The next morning did bring on excitement.  A Nazi submarine had forced us to stop.  They boarded the ship to steal the strange cargo and kidnap the archaeologist’s lady friend.  I did not know what happened to the archaeologist himself until I saw him climb aboard the deck of the Nazi sub.  That was one crazy son of a bitch, I thought.  I liked him.

Not having his lady with him any longer, I felt like he’d need some backup.  Especially if that sub were going to a Nazi base; the lion’s den.  I jumped overboard and swam after it.

I made it to the Nazi base, but was quickly captured.  I don’t know why they didn’t kill me immediately.  Instead, I was forced to attend this pointless but elaborate ceremony performed by another archaeologist in their party.  I saw that the renegade archaeologist and his lady friend were also forced to attend this ceremony.

Some crazy shit started happening during this bizarre ritual.  The generators started whining so loudly I could not hear what sounded like some kind of warning the archaeologist shouted to his lady.  I looked to see what the other archaeologist, Belloq, and the lead Nazis were doing about the ghastly occurrences.  That was when things got really weird.  They were unable to alter the course of this ceremony because they were too busy getting their faces melted off.

I later learned that the only protection from all the harm this ritual caused was to keep your eyes closed.  Luckily for me, I still wore my traditional pirate garb so only one of my eyes was exposed.  While this did protect my face from melting off, I did not escape the event completely unscathed.  I lost vision in my right eye, the one the eye patch did not cover.

</fiction>

That is the story I would like to tell about the lack of vision in my right eye.

The real reason isn’t completely known to me yet, which is why I felt the need to invent my own above.

While camping over labor day weekend this year, I noticed my vision was blurry.  It took me a couple days to notice that this problem was isolated to only my right eye.  I then went to an eye doctor who assumed it was due to complications from diabetes.

One of the things I always hated about being diabetic was that anything that happens to you is assumed to be caused by it.  As an example, I was rough-housing with another kid in middle school during recess one day.  I jumped on his back and he flipped me over his back and rammed me into the ground with a very WWF-esque move.  This maneuver broke my collar bone.  When the nurse called my Mom to tell her about the incident the first question out of her mouth was, “was his blood sugar low?”

Back to the here and now.  The first eye doctor referred me to a second, who also thought the vision problem was most likely diabetes related, but wanted to rule out anything else.  While ruling other things out, they found symptoms of me possibly having MS.  I have a neurology appointment this week, and another ophthalmology appointment a week after.  Hopefully between those two I get a more definitive answer.  The good thing about it possibly being diabetes related is that my vision will return, or so the doctors tell me.  I haven’t heard or looked into what the outcome will be if its MS, but I’ll obviously have bigger problems to worry about.  The moral of this story is be careful what you wish for.

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Posted by breeze773

Roll your own soda

October 20, 2012

All you need for fun flavors of soda.

I know I haven’t gotten rolling with too many tales of being on the drink with diabetes, but I’m switching gears for this post to lighten things up.  You can always use the product of this post to make some sugar free mixers and invent some fun adult beverages with them.

I’ve been thinking about making my own soda for about a year now.  Last night, I finally pulled the trigger.

SodaStream  has been on my radar, but I’ve avoided buying the kit because the premade mixes they have available use sugar substitutes that I’m not fond of.  As a side rant, I’m not fond of any of them other than Stevia these days.  I believe SodaStream’s mixes have either Splenda or some flavor of aspartame.  I am suspicious of both.

I put the idea of making my own mix in the back of my mind with the processing priority set to low.  Some time later I looked into it again.  All the SodaStream does is carbonate water.  I asked myself, if that’s the case couldn’t I flavor the water with whatever I want?  Yes.  My first thought was to use flavor extracts that are typically used for baking.  There are all kinds of fun and typical soda flavor options like root beer and cream soda, but I couldn’t find those at the local grocery store.  After the successful trial last night I did order some online from, Faeries Finest.

For last night’s trial I bought good old, non-sweetened Kool-Aid, rather a knock off thereof.  Kool-Aid is the original water flavoring with all kinds of great flavor options.  Being a diabetic, our family never got to take advantage of the cheap little packets where all you had to do was add that and a ton of sugar to water to hydrate your kids on a hot summer day.  It was actually a little hard to find the packets that weren’t pre-sweetened yesterday in my grocery store.  They were buried at the bottom of the aisle.  I hope those mixes aren’t going extinct.  Each packet is about $0.19 each so I stocked up with my and my wife’s favorite flavor; grape.

Without further adieu, here’s the recipe.

1 unsweetened packet of your favorite Kool-Aid flavor.

1 Liter of water

1 Teaspoon of liquid Stevia Extract

A couple notes on those ingredients.

The kool-aid mix calls for 2 quarts of water per packet.  A liter is roughly the same amount as a quart and I used only one to have more intense flavor.

There are a lot of Stevia-based sweeteners out there now, but don’t be fooled.  Most of them are mixed with some other sugar or sugar substitute like splenda or another form of sucralose.  Don’t get any of them.  Get pure stevia.  One teaspoon of stevia extract equals 1 cup of table sugar, which is also the amount the Kool-Aid calls for.  I overdid this one too, and it worked out fine.  There are  some times that stevia aftertaste lingers in things I make with it, but this soda was all grape but still sweet.

The outcome was delicious.  If you’re a diabetic who drinks gallons of soda like me, but are concerned about large quantities of aspartame putting holes in your brain, give this a shot.  You won’t be disappointed.

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Posted by breeze773

Why now?

October 14, 2012

If you knew me really well you’d know that I’ve had type 1 diabetes for over thirty years.  There are only a few who fall on that list, by the way.  That is the first reason for starting this blog.  I really don’t mention that I’m diabetic.  Ever.  When I feel the need to test or shoot up, I run to the closest restroom like I’m a superhero who won’t don his cape in public for fear of revealing his secret identity.  So this is a diabetes coming out of sorts.

The second, more immediate reason is that about a month ago I began to lose vision in my right eye.  As an example of how bad my vision currently is, when I close my left (good) eye I can see the black border of my computer monitor and a white blur from Word, but I can’t see any of the text I’ve written.  It’s not blurry.  It just ain’t there.  So, I went to the doctor.

There will be many more posts on that topic later, but there’s still a chance that the loss of vision is not diabetes related, but let’s hypothetically say it is for now.

The last big reason I want to do this is because I myself don’t have a lot of availability to people who have type 1 at all, let alone ones who are social drinkers.  Hopefully, some of you like me will see this as a place to find a kindred spirit.

I see doctors more often than your average bear, especially now that this eye problem has cropped up.  I find that most of them will tow the medical profession’s company line of, “you need to control your blood sugars, so don’t eat or drink anything you’re not supposed to.”  The “not supposed to” list is a long one.  That mentality doesn’t leave a lot of room for variability.  The lack of openness to variation on any of the factors that affect blood glucose made me over-compensate and start to change them all.  I’m a man who goes from one extreme to the other.  “If insulin lowers my blood sugar then if I eat an entire pizza, I’ll just take more insulin,” is what I always told myself.  That’s great in theory if you have enough data to know how many more carbs that pizza is and what your carb to insulin ratio should be.  I did not know those things.  Not well enough anyway.

I’m already digging myself a hole, right?  Then came college–of course.  Alcohol was flowing freely everywhere I wanted to be.  “Let’s drink before the football game.”  “Let’s drink before we go see that movie.”  “Let’s drink before we go out–to drink.”  Alcohol was that awkward dorm buddy you brought along to parties because you never knew what crazy thing he was going to do next.  Unfortunately, that crazy thing caused problems more often than turn the night into a hell of a lot more fun.

So, I started drinking.  Not a lot, at first.  I would dabble and make sure I still felt ok.  That feeling was never verified by a glucose test, however.  After gaining some comfort with my immediate safety not being at risk, I amped things up and drink more in quantity and frequency.  Nothing significant happened to me early in those days.  My pancreas or liver never spontaneously combusted after a night out and the fact that I didn’t test only enforced the notion that I could just wing it.  It was a bad habit I developed over the last twenty-ish years.  Now is the time to change the habit.

One current philosophy I have on life is to try to do things in moderation.  This goes against my natural tendency to bounce between extremes, but I think it introduces a more sustainable change to whatever aspect of your life you are applying it to.  This is why I’m not saying quit now and don’t look back.  Unless you are more able to go extreme.  In that case,  don’t think about adding the wildcard of change that alcohol introduces to your glucose management.  Let this be the only post you read.  To the rest of you, I’m going to tell you stories that you can consider anything from cautionary tales to commiserating conversations over a virtual drink.

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Posted by breeze773